Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $11.22 / $15.49	Facility	26	$11.22	$11.22	$15.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $67.61 / $194.98	Professional		$32.36	$67.61	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.20 / $50.12	Professional	26	$10.96	$18.20	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $48.98 / $147.91	Professional	TC	$34.67	$48.98	$147.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $54.95 / $69.18	Professional		$12.88	$54.95	$69.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.13 / $15.14	Professional	26	$12.59	$14.13	$15.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $50.12 / $69.18	Professional	TC	$40.74	$50.12	$69.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $21.88	Facility	26	$21.88	$21.88	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $117.49	Professional		$43.65	$61.66	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.85 / $29.51	Professional	26	$10.23	$15.85	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $45.71 / $102.33	Professional	TC	$32.36	$45.71	$102.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $100.00	Professional		$66.07	$74.13	$100.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $15.49 / $20.89	Professional	26	$13.80	$15.49	$20.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $58.88 / $79.43	Professional	TC	$52.48	$58.88	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $102.33	Professional		$42.66	$56.23	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $24.55	Professional	26	$10.96	$14.13	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $42.66 / $79.43	Professional	TC	$31.62	$42.66	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $77.62 / $97.72	Professional		$44.67	$77.62	$97.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $19.95	Professional	26	$9.55	$16.22	$19.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $61.66 / $79.43	Professional	TC	$35.48	$61.66	$79.43